the thread sufficient hold. All the stitches should
be as nearly as possible at equal distances from the border of the wound,
to prevent unequal strain, and the knots should be made at the side, not
over the wound. (Pl. XXVII, fig. 6.) When the wound is large and deep, care
should be taken to have an opening in the lowest part to allow for the
escape of the discharges.

In deep wounds which run crosswise of a limb or muscle it is often
advisable to use what is technically known as the "quilled suture," which
is most readily understood by reference to Plate XXVII, figure 7. To
accomplish this method a curved needle with an eye in the point and a
strong double thread should be used. The needle thus threaded is introduced
perpendicularly at least an inch from the wound on one side, carried across
below and brought out the same distance from the border of the cut on the
opposite side, the thread being seized and held in position while the
needle is withdrawn, leaving a loop of thread protruding on one side and
two loose ends on the other side of each stitch. When enough stitches have
been made, take a light piece of wood about the size of a lead pencil,
corresponding in length to the size of the wound or slightly longer, and
insert it through each of the loops, drawing up the free ends of the
threads, which should in turn be tied securely on a similar piece of wood
on that side.

PUNCTURED WOUNDS.--Owing to the uncertainty of their depth and the
structures they may involve, punctured wounds are by far the most dangerous
and difficult to treat. Not only is the extent of the damage hidden from
view, but the very character of the injury, as can be readily understood,
implies at least the possibility of deep-seated inflammation and
consequent discharge of pus (matter), which, when formed, is kept pent up
until it has accumulated to such an extent that it burrows by simple
gravity, as no other exit is possible. In this way foreign matters, such as
a broken piece of the stake or snag, or whatever caused the wound, may be
carried to an indefinite depth, or the cavity of a joint may be invaded and
very serious, if not fatal, consequences occur.

The danger is especially marked when the injury is inflicted on parts
liable to frequent and extensive motion, but all cases of punctured wounds
should receive unusual care, as no judgment can be accurately formed from
the external appearance of the wound. While a probe can ascertain the